Infected Healthcare Workers Research Articles

Correlation of the Adverse Event Following Immunization with the Severity of COVID-19 Infection in Health Care Workers in Padang

Background: Effective countermeasures to control the current COVID-19 pandemic are the implementation of health protocols and vaccinations. The problem that must be a concern after vaccination is post-immunization co-occurrence (AEFI), including COVID-19 vaccination. Another issue that is also a concern after vaccination is the incidence of being infected with COVID-19. The purpose of this study was to determine the incidence of post-vaccination COVID-19 infection in health workers in the city of Padang and its association with the incidence of COVID-19 vaccine AEFIs. 
 Methods: The study used a descriptive-analytic design with a retrospective cohort method. The research will be carried out in all hospitals in Padang, and sampling will be carried out for 2 months, from November to December 2021. Officers who are confirmed to have COVID-19 after vaccination and meet the inclusion criteria are healthcare workers who have received at least 2 vaccines and are willing to fill out a Google form.
 Results: The characteristics of health workers in Padang who were confirmed to have COVID-19 after 2 vaccinations were mostly (68.1%) early adults (26-35 years), the sex was mostly female as much as 77.3%, and most professions were workers. Paramedics (nurses or midwives) as much as 57.0%. The most comorbid obesity is as much as 3.4%. Nutritional status assessed by BMI showed that obesity (37.7%) and normal nutritional status (32.9%) had almost the same proportion. Almost all health workers with or without AEFI experience mild COVID-19, as many as 98%, and experience COVID-19 infection 28 days after vaccination.
 Conclusion: The incidence of AEFI is not related to the severity of post-vaccination COVID-19 infection in health workers in Padang.

Effectiveness and resource utilization of hospital-based contact tracing of patients and health care workers with COVID-19 at a tertiary teaching hospital in Thailand

BackgroundThe benefits of contact tracing in health care workers (HCWs) and patients in hospital have rarely been evaluated. This study aimed to assess the yield of contact tracing in order to evaluate the usefulness of resource utilization. MethodsData were collected from 1 April 2021 to 31 March 2022 at teaching hospital in Thailand. The team was notified if any HCW or patient admitted outside COVID-19 designated areas were tested positive. Those with high-risk exposure identified by the team needed to leave from work for 14 days and 2 PCR tests as early as possible and day 14 after the exposure. ResultA total of 4,292 HCWs and 422 patients were exposed to 575 COVID-19 cases and were identified as high-risk contacts, leading to 50,312 days of quarantine and 9,333 PCR tests. The secondary attack rate was 3.42%, which was more common in patients than in HCWs (OR = 1.82, 95%CI = 1.17–2.85, p = 0.0082). Close contact with patients had more secondary attack rates than with HCWs (OR = 1.51, 95%CI:1.01–2.25, p = 0.045). Among those who had close contact with patients, patients but not HCWs had increased risk of infection (OR = 2.86; 95%CI:1.24–6.62; p = 0.0138, OR = 1.06; 95%CI:0.63–1.77; p = 0.834, respectively). The positivity rate of high-risk close contact HCWs was 2.28 per 1,000 person-days after contact, as compared to the positivity rate of low-risk close contact with symptoms at 0.35 per 1,000 person-days during the same period. ConclusionsHospital-based contact tracing could identify more infected HCWs than symptomatic testing alone. Identifying more infected HCWs could potentially prevent infection in both HCWs and patients.

Persistence of Anti-S1 IgG against SARS-CoV-2 Eight Months after the Booster Dose of Vaccine in Naive and Previously Infected Healthcare Workers

Our aim was to evaluate the immune response of healthcare workers included in the RIPOVAC study, after receiving a booster dose (third dose), in terms of intensity and persistence of induced antibodies. In the second phase of the RIPOVAC study, between December 2021 and January 2022, eight months after the second dose, 389 voluntary, immunocompetent, non-pregnant healthcare workers received a booster dose of SARS-CoV-2 vaccine, and a serum sample was obtained. Two groups of patients were established: with and without previous SARS-CoV-2 infection. In order to quantify anti-S1 IgG (AU/mL) we used CMIA (Abbott). All of the health workers were anti-S IgG positive 8 months after receiving the booster dose of the vaccine, with a mean of 17,040 AU/mL. In 53 patients without previous infection, antibody levels increased by a mean of 10,762 AU/mL. This figure is seven times higher than the one produced after the second dose (1506 AU/mL). The booster dose produces a robust elevation of the antibody level, which persists at 8 months, with levels significantly higher than those reached after the second dose, which allow one to predict a persistence of more than one year. The study demonstrates the efficacy of the booster dose of anti-SARS-CoV-2 vaccines.

The Incidence Proportion of SARS-CoV-2 Infections and the Percentage of Deaths among Infected Healthcare Workers in Poland.

(1) Background: The incidence proportion of SARS-CoV-2 infection among healthcare workers (HCWs) in Poland is not exactly known. This study aims to present secondary epidemiological data identifying the scale of the spread of novel coronavirus infection and the estimation of vaccination coverage in selected professional groups of HCWs in Poland. (2) Methods: The secondary epidemiological data included both the number of infections and infection fatality rate (IFR) in individual occupational groups, which occurred throughout the observation period (January 2021-July 2022), both in the country and in individual voivodeship (administrative area). (3) Results: The incidence proportion of SARS-CoV-2 infections among HCWs was 16.48%. The highest percentage of infected workers concerned laboratory scientists (21.62%) and paramedics (18%). The highest frequency of infections among HCWs occurred in the province of Zachodnio-Pomorskie (18.9%). Due to COVID-19, 558 healthcare workers died during the analysed period, mostly nurses (n = 236) and doctors (n = 200). The results regarding the vaccination coverage of HCWs against COVID-19 indicate the highest percentage of vaccinated were among doctors (83.63%) and the lowest among physiotherapists (38.2%). (4) Conclusions: In general, the percentage of infections was high in Poland during the pandemic (16.48%). Significant territorial differences were observed in the frequency of infections, deaths, and percentage of vaccinated workers in individual voivodeships.

Combining epidemiological data and whole genome sequencing to understand SARS-CoV-2 transmission dynamics in a large tertiary care hospital during the first COVID-19 wave in The Netherlands focusing on healthcare workers

BackgroundHealthcare facilities have been challenged by the risk of SARS-CoV-2 transmission between healthcare workers (HCW) and patients. During the first wave of the COVID-19 pandemic, infections among HCW were observed, questioning infection prevention and control (IPC) measures implemented at that time.AimThis study aimed to identify nosocomial transmission routes of SARS-CoV-2 between HCW and patients in a tertiary care hospital.MethodsAll SARS-CoV-2 PCR positive HCW and patients identified between 1 March and 19 May 2020, were included in the analysis. Epidemiological data were collected from patient files and HCW contact tracing interviews. Whole genome sequences of SARS-CoV-2 were generated using Nanopore sequencing (WGS). Epidemiological clusters were identified, whereafter WGS and epidemiological data were combined for re-evaluation of epidemiological clusters and identification of potential transmission clusters. HCW infections were further classified into categories based on the likelihood that the infection was acquired via nosocomial transmission. Secondary cases were defined as COVID-19 cases in our hospital, part of a transmission cluster, of which the index case was either a patient or HCW from our hospital.FindingsThe study population consisted of 293 HCW and 245 patients. Epidemiological data revealed 36 potential epidemiological clusters, with an estimated 222 (75.7%) HCW as secondary cases. WGS results were available for 195 HCW (88.2%) and 20 patients (12.8%) who belonged to an epidemiological cluster. Re-evaluation of the epidemiological clusters, with the available WGS data identified 31 transmission clusters with 65 (29.4%) HCW as secondary cases. Transmission clusters were all part of 18 (50.0%) previously determined epidemiological clusters, demonstrating that several larger outbreaks actually consisted, of several smaller transmission clusters. A total of 21 (7.2%) HCW infections were classified as from confirmed nosocomial, of which 18 were acquired from another HCW and 3 from a patient.ConclusionThe majority of SARS-CoV-2 infections among HCW could be attributed to community-acquired infection. Infections among HCW that could be classified as due to nosocomial transmission, were mainly caused by HCW-to-HCW transmission rather than patient-to-HCW transmission. It is important to recognize the uncertainties of cluster analyses based solely on epidemiological data.

Resilient Hospital Design: From Crimea War to COVID-19.

Serious COVID-19 nosocomial infection has demonstrated a need to design our health services in a different manner. Triggered by the current crisis and the interest in rapid deployable hospital, this article discusses how hospital building layouts can be improved to streamline the patient pathways and thus to reduce the risk of hospital-related infections. Another objective of this work is to explore the possibility to develop flexible and scalable hospital building layouts through modular construction. This enables hospitals to better cope with different future demands and thereby enhance the resilience of the healthcare facilities. During the first wave of COVID-19, approximate one-seventh to one-fifth COVID-19 patients and majority of infected healthcare workers acquired the disease in NHS hospitals. Similar issues emerged during the Crimean War (1853-1856) when more soldiers died from infectious diseases rather than of battlefield casualties in Scutari Hospital. This led to an important collaborative work between Florence Nightingale, who looked into this problem statistically, and Isambard Kingdom Brunel, who designed the rapid deployment Renkioi Hospital which yielded a death rate 90% lower than that in Scutari Hospital. While contemporary medical research and practice have moved beyond Nightingale's concept of contagion, challenges of optimizing hospital building layouts to support healing and effectively combat nosocomial infections still pose elusive problems that require further investigation. Through case study investigations, this article evaluates the risk of nosocomial infections of airborne transmissions under different building layouts, and this provides essential data for infection control in the new-build or refurbished healthcare projects. Improved hospital layout can be achieved through reconfiguration of rooms and concourse. Design interventions through evidence-based infection risk analysis can reduce congestion and provide extra separation and compartmentalization which will contribute the reduced nosocomial infection rate. A resilient hospital shall be able to cope with unexpected circumstances and be flexible to change when new challenges arise, without compromising the safety and well-being of frontline medical staff and other patients. Such an organizational resilience depends on not only flexible clinical protocols but also flexible hospital building layouts. The latter allows hospitals to get better prepared for rapidly changing patient expectations, medical advances, and extreme weather events. The reconfigurability of an existing healthcare facility can be further enhanced through modular construction, standardization of building components, and additional space considered.

Investigating the Current Status of SARS-CoV-2 Antibodies in Hospital Staff.

The coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 had reported over 676 million cases by March 2023. The main aim of this study is to investigate whether the levels of anti-S and anti-N antibodies could precisely indicate the degree of protection against SARS-CoV-2 and affect the probability or time of contracting COVID-19. In this study, a serosurveillance study was conducted in healthcare workers (HCWs) at a regional hospital in Taiwan to evaluate their antibody levels based on infection and vaccination status. Of 245 HCWs enrolled, all have been vaccinated prior to infection. Of these, 85 participants were infected by SARS-CoV-2, while 160 participants were not infected at the time of blood sample collection. The level of anti-SARS-CoV-2 S antibody was significantly higher in the infected HCWs than in the non-infected participants (p < 0.001). It is worth noting that the mean duration between the administration of the last dose of the vaccine and the occurrence of SARS-CoV-2 infection was 5.61 ± 2.95 months. Our follow-up survey revealed that the non-infected group had significantly higher levels of antibodies compared to the infected group (all p < 0.001). In conclusion, this study suggests that the level of antibodies could serve as a reflection of the protective efficacy against SARS-CoV-2 infection. It has the implication for vaccine decision-making policies in the future.

Assessment of the Risk and Symptoms of SARS-CoV-2 Infection Among Healthcare Workers During the Omicron Transmission Period: A Multicentric Study from Four Hospitals of Mainland China

The SARS-CoV-2 omicron variant emerged and spread rapidly among the population in the early stage of China's normalized prevention and control in December 2022. Healthcare workers (HCWs) are particularly exposed to SARS-CoV-2, it is important to evaluate the impact of the omicron pandemic on HCWs in China.A self-administered online survey was conducted on infected HCWs from four hospitals of Taizhou. A total of 748 HCWs received the survey via DingTalk, and 328 responded to the questionnaire. The risk factors were investigated using univariate and multivariate logistic regression analysis.By December 20, 2022, 748 HCWs tested positive by PCR, and the infection rate was 11.4% (748/6581). Among 328 respondents, the most common symptoms were cough (88.4%), fever (83.5%), runny nose (77.1%), sore throat (73.2%), headache (70.1%), muscle aches (67.1%), and fatigue (53.4%). 69.8% (229/328) of the participants had five or more major onset symptoms, while no severe case was observed. The multivariate analysis indicated that the poor sleep quality (OR = 2.29, 95% CI: 1.31-4.02, P = 0.004) was an independent risk factor for more major onset symptoms, while wore gloves ≥95% times in working (OR = 0.49, 95% CI: 0.28-0.85, P = 0.011) was significantly related to fewer symptoms. In addition, 239 (72.9%) recipients reported high fever (temperature ≥38.5°C), less common cold (≤3 vs >3 times/year, OR = 2.20, 95% CI: 1.05-4.65, P = 0.038) was significantly associated with high fever.Our findings imply rapid transmissibility of omicron and multiple-onset symptoms among HCWs. Improved autoimmunity and self-protection measures for HCWs may be helpful in controlling infection and clinical symptoms. Our results provide empirical reference values for improved countermeasures and protective measures for major public health emergencies.

The prevalence and determinants of SARS-CoV-2 infections among healthcare workers, results of a cross-sectional study in the Silesian Voivodeship.

A significant proportion of healthcare workers (HCWs) had been infected with SARS-CoV-2, which complicated the organization of patient care during the COVID-19 pandemic. However, the exact scale of infection prevalence among the group of HCWs is not known, therefore this study aimed to assess the prevalence of SARS-CoV-2 infection among HCWs in the Silesian voivodeship, Poland, and to define its determinants. The cross-sectional study was conducted in 2 multidisciplinary hospitals in the Silesian voivodeship during the period October 2021-February 2022. The standardized WHO questionnaire Surveillance protocol for SARS-CoV-2 infection among health workers was completed by 242 HCWs. To assess the prevalence of SARS-CoV-2 infection and its determinants, such as personal, occupational, and work environment-related conditions and preventive behaviors, the collected data were subjected to statistical analysis. For this purpose, descriptive and analytical statistics (significance of differences in χ2 test) were used. Almost half (42.6%) of subjects were infected with coronavirus, most frequently care assistants (57.1%) and paramedics (50%). People suffering from chronic diseases were infected significantly more often (p < 0.001). The majority of the infected HCWs declared previous contact with COVID-19 patients (56.3%). Unfortunately, 10.3% of respondents refused to be vaccinated against COVID-19, most often care assistants (38.1%) and nurses (10.6%). The determinants such as sex, age, occupation, place of work (ward), participation in occupational safety and health training, use of personal protective equipment (PPE), or preventive behaviors did not significantly affect the risk of infection (p > 0.05). Even though the PPE was used and the percentage of fully vaccinated HCWs against COVID-19 was high (89.7%), the frequency of SARS-CoV-2 infected HCWs remains high at 42.6% (95% CI: 40.7-44.5%). The main determinants of SARS-CoV-2 infection risk among HCWs were previous contact with infected individuals and the presence of chronic disease. Int J Occup Med Environ Health. 2023;36(2):201-13.

Front-Line vs Second-Line Healthcare Workers: Susceptibility Prediction to COVID-19 Infection in a Tertiary Care Teaching Institute.

Background Since the beginning of the novel coronavirus disease in Wuhan city of China in 2019 and its spreading worldwide and taking the form of a pandemic, many healthcare workers (HCWs)were affected by coronavirus disease 2019 (COVID-19) infection. Though we have used many types of personal protective equipment(PPE) kitswhile taking care of COVID-19 patients, we have seen COVID-19 susceptibility in different working areas were different. The pattern of infection in different working areas depended on HCWsfollowing COVID-19 appropriate behavior. Therefore, we planned to estimate the susceptibility of front-line HCWs and second-line HCWs to getting COVID-19 infection. Aim To determine the risk of COVID-19 in front-line healthcare workers as compared to second-line healthcare workers. Method and materials We planned a retrospective cross-sectional analysis of COVID-19-positive healthcare workers from our institute within six months. Their nature of duty was analyzed and they were divided into two groups: 1) Front-line HCWs were defined as those who were working or who have worked in screening areas of the outpatient department (OPD)or COVID-19 isolation wards within the prior 14 days and provided direct care to patients with confirmed or suspected COVID-19. 2) Second-line HCWs were those who were working in the general OPD or non-COVID-19 areas of our hospital and did not have contact with COVID-19-positive patients. Results A total of 59 HCWs became COVID-19 positive during the study period, 23 as front-line and 36 as second-line HCWs. The mean (SD) duration of work as a front-line worker was 51 and as a second-line worker was 84.4 hours. Fever, cough, body ache, loss of taste, loose stools, palpitation, throat pain, vertigo, vomiting, lung disease, generalized weakness, breathing difficulty, loss of smell, headache, and running nose were present in 21 (35.6%), 15 (25.4%), 9 (15.3%), 10 (16.9%), 3 (5.1%), 5 (8.5%), 5 (8.5%), 1 (1.7%), 4 (6.8%), 2 (3.4%), 11 (18.6%), 4 (6.8%), 9 (15.3%), 6 (10.2%) and 3 (5.1%), respectively. To predict the risk of getting COVID-19 infection in HCWs, binary logistic regression with COVID-19 diagnosis as the output variable was modeled with hours of working in COVID-19 wards as front-line and second-line workers as independent variables. The results showed that there was a 1.18 times increased risk of acquiring the disease for every one-hour excess of working as a front-line worker, whereas, for second-line workers, it was slightly lower, with a 1.11 times increased risk for developing COVID-19 disease with every one hour increase in duty hours. Both these associations were statistically significant (p=0.001 for front-line and 0.006 for second-line HCWs). Conclusion COVID-19 has taught us the importance of COVID-19 appropriate behavior in preventing the spread of respiratory organisms. Our study has shown that both the front-line and second-line HCWs are at increased risk of getting the infection and proper use of a PPE kit or mask can decrease the spread of such respiratory pathogens.

Demographic and risk characteristics of healthcare workers infected with SARS-CoV-2 from two tertiary care hospitals in the United Arab Emirates.

Understanding the transmission dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers (HCWs) and their social contacts is crucial to plan appropriate risk-reduction measures. To analyze the socio-demographic risk factors and transmission of SARS-CoV-2 infection among HCWs in two tertiary care hospitals in Dubai, United Arab Emirates. The demographic and clinical characteristics were available for all HCWs in both facilities from the human resources department. A cross-sectional survey was conducted from January-April 2022 among HCWs who tested positive through Reverse Transcriptase Polymerase Chain Reaction of the nasopharyngeal swab for SARS-CoV-2 between March 2020 and August 2021 in two tertiary-level hospitals. The survey included questions on demographics, work profile, characteristics of coronavirus disease 2019 (COVID-19), and infection among their household or co-workers. The survey also checked the knowledge and perception of participants on the infection prevention measures related to SARS-CoV-2. Out of a total of 346 HCWs infected with SARS-CoV-2, 286 (82.7%) HCWs consented to participate in this study. From the sample population, 150 (52.5%) of participants were female, and a majority (230, 80.4%) were frontline HCWs, including 121 nurses (121, 42.4%). Only 48 (16.8%) participants were fully vaccinated at the time of infection. Most infected HCWs (85%) were unaware of any unprotected exposure and were symptomatic at the time of testing (225, 78.7%). Nearly half of the participants (140, 49%) had co-infection among household, and nearly one-third (29.5%) had co-infection among three or more household. Another 108 (37.8%) participants reported cross-infection among co-workers. The frontline HCWs were significantly more infected (25.1% vs 8.6%, P < 0.001) compared to non-frontline HCWs. Another significant risk factor for a high infection rate was male sex (P < 0.001). Among the infected frontline HCWs, a significantly higher proportion were male and shared accommodation with family (P < 0.001). COVID-19 vaccination significantly reduced the infection rate (83.2% vs 16.8, P < 0.001) among HCWs. Most participants (99.3%) were aware about importance of appropriate use of personal protective equipment. However, only 70% agreed with the efficacy of the COVID-19 vaccination in preventing an infection and severe disease. The risk profiling of the HCWs infected with SARS-CoV-2 found that working at frontline and being male increase the rate of infection. COVID-19 vaccination can effectively reduce the rate of transmission of SARS-CoV-2 among HCWs.

Clinical characteristics of post-vaccination COVID-19 infection in health care workers exposed to Delta and Omicron variants in a COVID-19 dedicated facility from Qatar

Clinical characteristics of post-vaccination COVID-19 infection in health care workers exposed to Delta and Omicron variants in a COVID-19 dedicated facility from Qatar

COVID-19 Vaccination Among Healthcare Workers: Trend and Protection in a Tertiary Care Hospital in Northern India.

Background Coronavirus disease 2019 (COVID-19) is an infectiousdisease that poses health risks to everyone exposed to the virus and frontline healthcare workers (HCWs) are at very high risk. COVID-19 vaccines have been developed to offer protection from the disease and reduce the severity of illness. Objective This questionnaire-based cross-sectional survey aimed to determine COVID-19 vaccination trends and protection among HCWs in a dedicated COVID-19 tertiary care hospital in Northern India. Methods A printout of the questionnaire was distributed. Part 1 of the questionnaire included voluntary consent and demographics information, and part 2 dealt with COVID-19 vaccination, COVID-19 illness, and post-vaccination illness. The outcomes of the study comprised trends and protection offered by COVID-19 vaccination, post-vaccination side-effects, and reasons for vaccine hesitancy. The responses were analyzed using Stata version 15.0. Results: A total of 256 HCWs were approached to take the questionnaire, out of whom 241 consented to participate in the survey. One-hundred and fifty-five (64.3%) of these HCWs were fully vaccinated, 53 (21.9%) were partially vaccinated, and 33 (13.7%) were non-vaccinated. The overall rate of infection was 45.64% (110/241). The rate of infection was 58.18% among non-vaccinated HCWs, 21.81% after partial vaccination, and 20% after full vaccination. The odds of infection among vaccinated versus non-vaccinated HCWs was 0.338 (95% CI: 0.224 to 0.512; P<0.001). The overall hospitalization rate among infected HCWs was 6.36% and there was no incidence of hospitalization among fully vaccinated HCWs. Conclusions: Vaccination was shown to reduce the rates of infection and hospitalization among HCWs. A sizeable number of HCWs remained unvaccinated due to either recent COVID-19 infection or apprehension about vaccine-related side-effects.

Epidemiological situation on viral hepatitis В and С among medical workers in the Voronezh region

One of the leading problems of modern health care is nosocomial infection of health care workers with bloodborne infections viruses, including parenteral viral hepatitis B and C. The aim of the study was to assess the frequency of detection of markers of hepatitis B and C based on the results of screening studies and the incidence of viral hepatitis B and C among medical workers and the general population of the Voronezh region, to analyze the structure of emergency situations in medical organizations. A retrospective descriptive study was conducted, the materials of which were data on the frequency of occurrence of markers of parenteral hepatitis, the incidence of viral hepatitis B and C among medical workers, and the frequency of registration of emergency situations. Analysis of the incidence and results of screening examinations for markers of viral hepatitis B and C among medical workers in the Voronezh region for the period 2011–2018 revealed a pronounced trend towards a decrease in the prevalence of this pathology. However, the indicators remain at a consistently high level among the staff of the hemodialysis, hematology, and surgery departments. The annual frequency of registering emergencies for the specified period was from 1.7 to 3.1 per 1000 workers. It has been established that most often medical accidents occur among middle medical personnel and auxiliary health care workers. More than half of the respondents (53.0 %) answered in the affirmative to the question about the emergency situation in their professional activities, only a fourth (26.0 %) carried out emergency postexposure prophylaxis of viral hepatitis B. Insufficient adherence of medical workers to timely accounting of injuries, low level of knowledge of algorithms of behavior in an emergency situation, a significant underestimation of emergency situations in medical organizations require close attention.

Victoria's surgical response to the COVID-19 pandemic: the first two years.

Victoria suffered three major waves during the first two years of the COVID-19 pandemic. Melbourne became the longest locked down city in the world at 267 days. This narrative review documents the chronological waves of COVID-19 in Victoria and key themes influencing the State-wide surgical response. In 2020, Victoria needed to secure supplies of personal protective equipment (PPE) and later, recognizing the importance of aerosol transmission, introduced a respiratory protection program to protect health care workers (HCWs) with fit-tested N-95 masks. It established routine preoperative PCR testing for periods when community prevalence was high and developed strategies to restrict elective surgery when hospital capacity was limited. In 2021, three short-term outbreaks were contained and eliminated whilst vaccination of HCWs and the vulnerable was taking place. A third major wave (Delta) occurred July to November 2021, succeeded by another involving the Omicron variant from December 2021. Planned surgery waiting list numbers, and waiting times for surgery, doubled between March 2020 and March 2022. In early 2022, almost 300 patients underwent surgery when infected with Omicron, with a low mortality (2.6%), though mortality was significantly higher in the unvaccinated (7.3% versus 1.4%). In conclusion, the Victorian response to COVID-19 involved tight state-wide social restrictions, contact tracing, furlough, escalating PPE guidance and respiratory protection. HCW infections were greatly reduced in 2021 compared with 2020. Pre-operative PCR testing gave confidence for emergency and urgent elective surgery to proceed during pandemic waves. Other elective cases were performed as health system capacity allowed, without compromising outcomes.

SG-APSIC1116: Assessing COVID-19 symptoms in infected healthcare workers in Vietnam

Objectives: In early 2021, when the COVID-19 vaccine was scarce in Vietnam, healthcare workers (HCWs) were prioritized for vaccination due to high risk of occupational exposure. However, there is some COVID-19 vaccine hesitancy within HCW communities. Assessing COVID-19 severity among vaccinated and nonvaccinated HCWs would contribute essential information to assure people of vaccine effectiveness and reduce vaccine hesitancy. Methods: We conducted a descriptive cross-sectional study at the National Hospital for Tropical Diseases in Hanoi, Vietnam, from May to June 2021. Clinical and epidemiological data from HCWs with positive polymerase chain reaction (PCR) results were collected. The severity of symptoms were classified according to Vietnam Ministry of Health guideline (Decision no. 3416 issued July 14, 2021) into 5 categories: asymptomatic, mild, moderate, severe, and critical conditions Results: Overall, 25 HCWs qualified for this study (14 women and 11 men), with a median age of 31 years. Among them, 3 HCWs were infected due to community exposure, and the rest were infected due to occupational exposure. Also, 3 HCWs received the Astra Zeneca vaccine before being infected with SARS-CoV-2 (one fully vaccinated with 2 doses and the other 2 had had the first dose). Categorized by the severity of infection, 28% were asymptomatic, 44% had mild symptoms, 20% had moderate symptoms, and 8% experienced severe symptoms. All 3 vaccinated HCWs showed only mild symptoms. Cough and sore throat were the main symptoms recorded (60%), followed by fever (56%). Blood test results did not show significant differences between the severe and mild COVID-19 groups. Conclusions: COVID-19 vaccination reduced the severity of COVID-19 in this small sample of HCWs. Full COVID-19 vaccination is strongly recommended for HCWs to reduce the spread of COVID-19 and to limit the number of cases with severe disease.

Seroprevalence of Hepatitis B virus infection and associated factors among health care workers in Southern Ghana

The World Health Organization estimates that 37% of Hepatitis B Virus (HBV) infections among Health Care Workers (HCWs) are due to percutaneous occupational exposure to blood and body fluids. In Ghana, occupational exposures are rising; however, the burden of HBV infection in HCWs remains unknown. Our study estimated the prevalence of HBV surface antigens and associated factors among HCWs. We conducted a cross-sectional survey of 340 HCWs using a structured pretested questionnaire and screening for HBV surface antigens. Data were analyzed using SPSS version 20.0 with a level of significance set at <0.05. The overall crude prevalence of current HBV infection was 5.9 % (95% CI, 3.0-8.0). Adjusted prevalence by test performance was 5.8%. Prevalence was highest among males 10.2% (95% CI, 4.8-18.5), HCWs other than nurses and doctors 9.2% (95% CI, 4.5-16.2), and those working at lower-level facilities 9.7% (95% CI, 4.8-17.1). Training in the prevention of blood-borne infections was significantly associated with HBV infection (adjusted odds ratio 3.2; 95% CI, 1.1-9.1). HBV infection is high in this population. In addition to lifesaving interventions such as vaccination and the use of immunoglobulin, training in blood-borne infections could prevent new HBV infections among Ghanaian HCWs.

SARS-CoV-2 Breakthrough Infections in Health Care Workers: An Italian Retrospective Cohort Study on Characteristics, Clinical Course and Outcomes.

The aim of this study was to determine the characteristics, clinical course and outcomes of COVID-19 breakthrough infections (BIs) among healthcare workers (HCWs) of an Italian University Hospital. A retrospective observational study was conducted on 6111 HCWs, from January 2021 to February 2022. The study population was offered the full vaccination with BNT162b2 mRNA COVID-19 vaccine. To allow return to work after BI, the protocol required one negative nasopharyngeal RT-PCR swab followed by a medical examination to assess the HCW's health status. Laboratory tests, instrumental tests and specialist evaluations were carried out if necessary. The cases of BIs observed numbered 582 (9.7%). The frequency of BIs was significantly higher in females than in males (67% vs. 33%; p = 0.03), and in nurses than in all other professional categories (p = 0.001). A total of 88% of the HCWs affected by BI were still symptomatic after the negative swab. None of the instrumental tests carried out showed any new findings of pathological significance. All cases showed progressive disappearance of symptoms, such that no cases of long COVID and no hospitalization or deaths were recorded. Our results confirm that SARS-CoV-2 infections occur even after a full vaccination course; however, the clinical course is favorable and severe outcomes are reduced.

Temporal trends of COVID-19 antibodies in vaccinated healthcare workers undergoing repeated serological sampling: An individual-level analysis within 13 months in the ORCHESTRA cohort.

We investigated changes in serologic measurements after COVID-19 vaccination in 19,422 subjects. An individual-level analysis was performed on standardized measurements. Age, infection, vaccine doses, time between doses and serologies, and vaccine type were associated with changes in serologic levels within 13 months. Persistence of vaccine immunization is key for COVID-19 prevention. We investigated the difference between two serologic measurements of anti-COVID-19 S1 antibodies in an individual-level analysis on 19,422 vaccinated healthcare workers (HCW) from Italy, Spain, Romania, and Slovakia, tested within 13 months from first dose. Differences in serologic levels were divided by the standard error of the cohort-specific distribution, obtaining standardized measurements. We fitted multivariate linear regression models to identify predictors of difference between two measurements. We observed a progressively decreasing difference in serologic levels from <30 days to 210-240 days. Age was associated with an increased difference in serologic levels. There was a greater difference between the two serologic measurements in infected HCW than in HCW who had never been infected; before the first measurement, infected HCW had a relative risk (RR) of 0.81 for one standard deviation in the difference [95% confidence interval (CI) 0.78-0.85]. The RRs for a 30-day increase in time between first dose and first serology, and between the two serologies, were 1.08 (95% CI 1.07-1.10) and 1.04 (95% CI 1.03-1.05), respectively. The first measurement was a strong predictor of subsequent antibody decrease (RR 1.60; 95% CI 1.56-1.64). Compared with Comirnaty, Spikevax (RR 0.83, 95% CI 0.75-0.92) and mixed vaccines (RR 0.61, 95% CI 0.51-0.74) were smaller decrease in serological level (RR 0.46; 95% CI 0.40-0.54). Age, COVID-19 infection, number of doses, time between first dose and first serology, time between serologies, and type of vaccine were associated with differences between the two serologic measurements within a 13-month period.

Immune Status for Hepatitis B and Risk for Occupational Exposure Virus Among Italian Nurses

Background: Healthcare workers (HCWs) are considered at higher risk for hepatitis B virus infection compared to the general population, due to their potential contact with blood or body fluids and possible needle stick injuries. In turn, infected HCWs may be a risk for patients. Hepatitis B vaccination programs represent a strategic approach to control the infection. Objectives: In this study, we aimed to evaluate the serological status of HCWs employed at the teaching hospital of Rome Tor Vergata and their risk of occupational injuries after the adoption of directive 2010/32/EU. Methods: Medical records of 539 HCWs were evaluated during their occupational medical examination at the Tor Vergata teaching hospital (PTV). All subjects were screened for specific viral markers: Hepatitis B surface antibodies (anti-HBs IgG), antibodies to hepatitis core antigen (anti-HBc IgG), and hepatitis B surface antigen (HBsAg). Data regarding needlestick injuries were collected by the prevention service team during the same year. Results: In this sample population, we found five subjects (0.9%) positive to the HBsAg, and most of them (four) were born in foreign countries. Moreover, seven subjects (1.3% of our population) were HBsAg-positive and anti-HBc-positive. A protective anti-HBs titer was found in 462 out of 527 (85.7%) subjects. The risk of being serologically unprotected was higher in males and subjects aged 40 years or older. The nurses were more protected than other healthcare professionals considering the anti-hepatitis B surface antibody titer. In 2018, 16 needlestick injuries were reported among our population of HCWs, with a global risk of 2.9% per year. Conclusions: Although hepatitis B virus (HBV) infection rate among HCWs was similar to that of the general population, the risk of HBV transmission in HCWs was likely to be high due to suboptimal vaccination coverage.